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General NPI Number Information
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NPI Number | 1720302433
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Entity Type | Organization
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Legal Business Name | FRANKLIN TODD WORTHAM DDS, LLC
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 10767 KENAI SPUR HWY STE A
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City | KENAI
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State | AK
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Zip | 99611-7836
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Country | US
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Telephone | 907-252-1673
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Fax |
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Provider Business Mailing Address
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Address Line | 10767 KENAI SPUR HWY STE A
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City | KENAI
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State | AK
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Zip | 99611-7836
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Country | US
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Telephone | 907-252-1673
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. FRANKLIN T WORTHAM
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Credential |
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Telephone | 907-280-9585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AK1024
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License Number State | AK
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